Analysis of Patients were Transported by 119 Helicopter from Mountain Accident Scenes in Seoul

PURPOSE: Geographic problems can make it difficult for rescue teams to access emergency patients in the mountains. We developed the aeromedical relief program in conjunction with fire department helicopter EMS teams. This study describes the clinical experience of patients transported from the mountains in this program. METHODS: We reviewed the employed protocols and the medical records of patients transported to our hospital from the mountains by the aeromedical transport system from June 2006 to June 2007. RESULTS: Thirty-one patients were transported by helicopter during the study period, most of them (84%) from Mt. Bukhan. The time interval from call for help to hospital arrival was 80+/-56 min, and rescue time alone was 30+/-24 min. Eleven patients (36%) were pronounced dead on arrival, and 11 patients were admitted for management. The number of trauma patients were 24 (77%), who had an average RTS score (excluding the 11 patients who expired before arrival) of 11.7+/-0.6. When the ground team and the aeromedical team were dispatched at the same time, the total transport time was 54.0+/-22.8 min, compared to 133.0 +/-75.7 min when the aeromedical team was dispatched only upon the request of the ground team, a large and statistically significant difference. CONCLUSION: This study suggests that the helicopter transport system can be successfully employed to achieve early access to patients in the mountains. To optimize the current program, cooperation between hospital and the regional helicopter EMS is required.

Temporal Bone Fracture and Labyrinthine Concussion as Ataxic Gait in 21-Months-Old Child

Blunt head injury can concuss the membranous labyrinth against the otic capsule. This results in acute hypofunction of some portion of the vestibular neural substrate within the affected labyrinth. Both labyrinthine concussions and transverse temporal bone fractures produce acute unilateral vestibular hypofunction. We describe a 21-months-old child who presented with a ataxic gait for two days. It is difficult to make diagnosis of labyrinthine concussions and temporal bone fractures in children, for we can not know the exact history of trauma and can not perform complete neurologic examination in children. When child present with ataxic gait, the emergency physician should consider labyrinthine concussion and temporal bone fracture in the differential diagnosis and take temporal bone CT.